Abstract
Introduction
Posterior techniques of treatment in atlas–axis combined injury are reported less prone to failure of osteosynthesis. At the same time, however, more frequent occurrence of complications is presented, mainly consisting of higher blood loss, reduced wound healing, chronic pain, and possibility of injury of a. vertebralis. In addition, prone position is not suitable for elderly patients from the anesthesiologist perspective. On the contrary, the frequent failure of anterior osteosynthesis of dens axis because of osteoporosis calls for finding alternative solutions.
Patients and Methods
Between 2009 and 2013, 10 consecutive patients with combined C1/C2 fractures underwent triple anterior screw fixation in our hospital. The group consisted of 10 women. The age ranged between 67 and 90 years. The patients follow-up was 1 year.
Results
The operation was performed without complications in all patients. Early postoperative failure of screws in C1 was observed in one patient. Reoperation was required. The bone was healed in fracture of dens axis in eight patients according to CT examination. Pseudoarthrosis without clinical sequelae was found in two patients. None of the patients had neurological disorder and we had no patient deaths during the period under review.
Conclusion
This method allows simple and safe treatment of combined atlas–axis fractures.